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. 2022 Jul 1:17:1507-1521.
doi: 10.2147/COPD.S360983. eCollection 2022.

Qualitative Validation of COPD Evidenced Care Pathways in Japan, Canada, England, and Germany: Common Barriers to Optimal COPD Care

Anne Meiwald  1 , Rupert Gara-Adams  1 , Aleix Rowlandson  1 , Yixuan Ma  1 , Henrik Watz  2 , Masakazu Ichinose  3 , Jane Scullion  4 , Tom Wilkinson  5   6 , Mohit Bhutani  7 , Georgie Weston  1 , Elisabeth J Adams  1
Affiliations

Qualitative Validation of COPD Evidenced Care Pathways in Japan, Canada, England, and Germany: Common Barriers to Optimal COPD Care

Anne Meiwald et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. A comprehensive and detailed understanding of COPD care pathways from pre-diagnosis to acute care is required to understand the common barriers to optimal COPD care across diverse health systems.

Methods: Country-specific COPD care pathways were created for four high-income countries using international recommendations and country-specific guidelines, then populated with published epidemiological, clinical, and economic data. To refine and validate the pathways, semi-structured interviews using pre-prepared discussion guides and country-specific pathway maps were held with twenty-four primary and secondary care respiratory healthcare professionals. Thematic analysis was then performed on the interview transcripts.

Results: The COPD care pathway showed broad consistency across the countries. Three key themes relating to barriers in optimal COPD management were identified across the countries: journey to diagnosis, treatment, and the impact of COVID-19. Common barriers included presentation to healthcare with advanced COPD, low COPD consideration, and sub-optimal acute and chronic disease management. COVID-19 has negatively impacted disease management across the pathway but presents opportunities to retain virtual consultations. Structural factors such as insurance and short duration of appointments also impacted the diagnosis and management of COPD.

Conclusion: COPD is an important public health issue that needs urgent prioritization. The use of Evidenced Care Pathways with decision-makers can facilitate evidence-based decision making on interventions and policies to improve care and outcomes for patients and reduce unnecessary resource use and associated costs for the healthcare provider/payer.

Keywords: COPD diagnosis; COPD management; exacerbations; health policy; pathway mapping; qualitative.

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Conflict of interest statement

AM, RGA, YM, AR (at the time of the project), GW (at the time of the project), and EA work at Aquarius Population Health and have received consultancy fees from other pharmaceutical and MedTech companies unrelated to this work. Outside of the submitted work, TW reports receiving consulting fees and/or fees for attending lectures, meetings and conferences and/or travel expenses and/or research grants from My mhealth, AstraZeneca, GlaxoSmithKline, Synairgen, Bergenbio, UCB, UKRI, NIHR, Valneva, OM Pharma, Boehringer Ingelheim, Roche, Chiesi, Teva and Nutricia. TW is a founder, director and shareholder of My mhealth. TW has served on monitoring boards for trials sponsored by Synairgen and Valneva, and has applied for patents with GlaxoSmithKline and My mhealth. HW reports receiving consulting fees and/or fees/honoraria for attending/presenting lectures, meetings and conferences and/or travel expenses and/or grants from AstraZeneca, Boehringer Ingelheim, Chiesi, Novartis, Bayer, GlaxoSmithKline and Verona Pharma. HW has served on monitoring boards for AstraZeneca, Boehringer Ingelheim, Chiesi, Novartis, Bayer and GlaxoSmithKline. JS reports receiving consulting fees and/or fees/honoraria for attending/presenting lectures, meetings and conferences from AstraZeneca, Chiesi, Teva and Mundipharma. JS has received payment for expert testimony from Bush and Co Ltd. MB reports receiving consulting fees and/or fees/honoraria for attending/presenting lectures, meetings and conferences and/or travel expenses and/or grants from AstraZeneca, GlaxoSmithKline, Pfizer, Sanofi, Covis, Grifols, Boehringer Ingelheim, Valeo, The Lung Association of Saskatchewan, Alberta Lung and NWT, CIHR, Alberta Innovates, Novartis and Mereo. MB has a leadership or fiduciary role in the Canadian Thoracic Society and Alberta Health Services. GW reports receiving grants or contracts from Adelphi Values PROVE. MI reports no conflicts of interest. No other conflicts of interest were declared.

Figures

Figure 1
Figure 1
Overview of the Evidenced Care Pathway for patients with COPD from four countries.
See this image and copyright information in PMC

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References

    1. World Health Oraganization. The top 10 causes of death; 2021. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death. Accessed October 22.
    1. World Health Organization. Chronic obstructive pulmonary disease (COPD) fact sheet; 2021. https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pul.... Accessed August 18, 2021.
    1. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease: 2020 Report; 2020.
    1. Hurst JR, Skolnik N, Hansen GJ, et al. Understanding the impact of chronic obstructive pulmonary disease exacerbations on patient health and quality of life. Eur J Intern Med. 2020;73:1–6. doi:10.1016/j.ejim.2019.12.014 - DOI - PubMed
    1. Adeloye D, Chua S, Lee C, et al. Global and regional estimates of COPD prevalence: systematic review and meta–analysis. J Glob Health. 2015;5(2):020415. doi:10.7189/jogh.05-020415 - DOI - PMC - PubMed